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Aortic valve regurgitation

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	- Introduction - Causes - Diagnosis - Treatment
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Prevention and Self-care

Aortic valve regurgitation can also be prevented from high blood pressure by keeping blood pressure under control. High blood pressure can also cause the aorta to stretch out, which pulls the aortic valve leaflets apart and leads to regurgitation.

• Control of high blood pressure.
• Consuming less salt.
• Regular dental care.
• Maintaining a healthy weight.
• Exercise
• Regular cardiology check up.

Some cases of aortic insufficiency can be prevented by treating underlying disorders. For example, effective treatment of autoimmune disorders may prevent some damage to the aortic valve. High blood pressure can be managed with lifestyle changes and medicines. Following safer sex guidelines can prevents some STDs.

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Medical treatment

Heart failure due to aortic regurgitation can initially be treated with drugs. Unless aortic regurgitation is mild, surgery is ultimately almost always required. In the weeks before surgery, heart failure is treated with digoxin, diuretics, and a drug that dilates blood vessels and thus reduces the work of the heart, such as a calcium blocker, an angiotensin-converting enzyme (ACE) inhibitor, or hydralazine, plus a nitrate. An angiotensin II receptor blocker may be used when an ACE inhibitor cannot be used. Use of a pacemaker to increase the heart rate can sometimes help reduce the severity of heart failure.

Surgical treatment

The damaged valve should be surgically replaced with an artificial valve before the left ventricle becomes irreversibly damaged and heart failure becomes too severe. If regurgitation occurs quickly, the aortic valve is usually replaced as soon as possible. If the cause is endocarditis or aortic dissection, the valve may be repaired instead. Usually, echocardiography is performed periodically to determine how rapidly the left ventricle is enlarging, so that surgery can be scheduled at an appropriate time. People with aortic regurgitation, even when mild, are at increased risk for developing an infection of the valve (endocarditis). They need to take antibiotics before certain dental or surgical procedures.

Prognosis and survival

Without treatment, aortic regurgitation tends to worsen over time. The outlook is worse for older people, partly because many of them also have coronary artery disease. If heart failure develops, the outlook is also worse. After heart valve replacement, people over 75 tend to continue to have heart problems (including heart failure) and are more likely to die.

If a person does not have symptoms and the left heart chamber works well, he or she may remain on medicine for a long time. Successful replacement of the valve restores normal blood flow. The long-term outcome is usually very good. Artificial valves wear out over a period of years. Their function is monitored, and the valves are replaced as necessary. Some artificial valves require that the person take antibiotics before and after surgeries or dental work to avoid serious heart infections, and anti-coagulants to avoid blood clots, such as deep venous thrombosis.

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